Earlier Identification of Late Presenters HIV

The knowledge on HIV and AIDS a well as treatment options have made large progress since the 1980s. Still, 30 to 50% of all HIV infections in Germany are not diagnosed until they have reached a rather advanced stage. This carries enormous risks for both the patients and their partners. Frequently, “late presenters” are specifically those patients who, in their own perception and that of others, do not consider themselves at risk because they do not belong to the classical “risk groups”.

The reasons for diagnosing an HIV infection late are manifold and complex. Often, the patients delay seeing a doctor for fear of stigmatisation or as a result of poor access to health care. But physicians, too, tend to disregard the possibility of an HIV infection more often than not, and as a result do not perform the appropriate tests.

Problem

Early diagnosis of the infection provides benefits for patients, their partners and society as a whole. It not only facilitates treatment, it lowers mortality among infected patients as well as AIDS rates and the costs for society. And it reduces the risk of transmission. “Patients who know that they are infected behave differently. In addition, they get targeted treatment sooner.

Apart from that, treatment of “late presenters” is often very complex and carries an increased risk of side effects and [drug] interactions.

Actual Challenge

How may so-called “late presenters” with HIV be identified earlier, at the periphery and by general practicitioners (identification of hidden patients), thereby effecting their rapid referral to specialist centres (university hospitals) for treatment?